10种中药注射剂联合长春瑞滨+顺铂化疗方案治疗非小细胞肺癌的网状Meta分析

摘要

目的：采用网状Meta分析评价10种中药注射剂联合长春瑞滨＋顺铂（ NP）治疗非小细胞肺癌（ NSCLC）的价值。方法：检索Science Citation Index Expanded （ SCI-EXPANDED）、EMBASE、PubMed、Cochrane Library、CancerLit、中国学术期刊网络出版总库、维普中文科技期刊全文数据库（ VIP-CSJFD ）、中国生物医学文献数据库（ CBM ）、万方数据期刊论文资源（ WAN-FANG）、中国科学引文数据库（ CSCD）和中国中医药等数据库，同时检索在研研究和相关学术组织网站，补充其他检索获取所有中药注射剂联合NP治疗NSCLC的随机对照临床试验（ RCTs），按预先制定的纳入与排除标准筛选和纳入，并对纳入RCTs的质量进行质量评价，数据采用WinBugs软件进行分析。结果：共纳入10种中药注射剂，167个RCTs。网状Meta分析结果显示：以NP为共同干预措施，在生活质量方面，只有华蟾素注射液＋NP、鸦胆子油乳注射液＋NP和艾迪注射液＋NP分别与得力生注射液＋NP的差异有统计学意义；在恶心呕吐方面，只有得力生注射液＋NP与鸦胆子油乳注射＋NP，华蟾素注射液＋NP和鸦胆子油乳注射＋NP分别与复方苦参注射液＋NP、康莱特注射液＋NP、艾迪注射液＋NP，康艾注射液＋NP与复方苦参注射液＋NP、康莱特注射液＋NP、艾迪注射液＋NP之间的差异有统计学意义；在白细胞减少方面，只有鸦胆子油乳注射液＋NP与康莱特注射液＋NP和华蟾素注射液＋NP，康艾注射液＋NP与华蟾素注射液＋NP的差异有统计意义；在有效率方面，10种中药注射剂＋NP之间的差异无统计学意义。结论：基于网状Meta分析和测量指标排序核密度结果，以NP为共同干预措施，得力生注射液、参芪扶正注射液和鸦胆子油乳注射液较其他7种中药注射液相对有效。%Objective:To assess the clinical effects and safety of Chinese herb injection(CHI) combined vinorelbine and cisplatin ( NP) for non small cell lung cancer ( NSCLC ) based on the same comparison.Methods: The relative randomized controlled trials ( RCTs) of CHIs were searched from Science Citation Index Expanded ( SCI-EXPANDED) , EMBASE, PubMed,Cochrane Library, Can-cerLit, Chinese Knowledge Infrastructure,Chinese Scientific Journals Fulltext Database( VIP-CSJFD) ,Chinese Biomedical Literature Da-tabase( CBM) ,Wan-Fang Database( WANFANG) ,Chinese Science Citation Database( CSCD) and Traditional Chinese Medical Database System.The related references and website were also traced.The RCTs were screened according to the predefined inclusion and exclusion criteria,the related items were used to assess the quality of RCTs, data were analyzed by WinBugs software.Results:167 RCTs and 10 CHIs were finally included.The results of network Meta-analysis showed that, based on the NP intervention, there were significant differ-ence between only huachansu injection or yadanzyouru injection or aidi injection respectively and delisheng injection in quality of life. There were significant difference between only delisheng injection and yadanziyouru injection, huachansu injection or yadanziyouru injec-tion respectively and compound matrine injection or kanglaite injection or aidi injection, kang′ai injection and compound matrine injection or kanglaite injection or aidi injection in nausea and vomiting.There was no difference between 10 CHIs in efficacy.Conclusion:Based on the results of network Meta-analysis,delisheng injection,shengqifuzhe injection and yadanziyouru injection were more than other 7 CHIs based on the common intervention.